NPIMap

Organization Active NPI

Wake Spine and Pain Specialists, PC

  • Pain Medicine (Anesthesiology) Physician
  • Winston Salem, NC
National Provider Identifier
1376287714
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
WAKE SPINE AND PAIN SPECIALISTS, PC
Practice address
2912 Maplewood Ave
Winston Salem, NC 27103-4010
Phone
(336) 760-0706
Fax
(336) 760-1927
NPI assigned
Apr 22, 2022
Last updated
Apr 22, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
WAKE SPINE AND PAIN SPECIALISTS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Vijaysinha Mandhare, MDNPI 1891905287
Title
Medical Director
Phone
(919) 787-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X Primary

Addresses

Primary practice location

2912 Maplewood Ave
Winston Salem, NC 27103-4010

Mailing address

3801 Wake Forest Rd Ste 210
Raleigh, NC 27609-6864
Phone (919) 787-7246

National Provider Directory

National Provider Directory
Part of
Wake Spine and Pain Specialists PC

Locations

115 Kildaire Park Dr
Ste 205
Cary, NC 27518

1357 Walter Reed Rd
Ste 101
Fayetteville, NC 28304
Phone (910) 504-3506

958 Vandora Springs Rd
Garner, NC 27529
Phone (919) 772-3487

3100 Blue Ridge Rd
Ste 203
Raleigh, NC 27612
Phone 9197877246116

3410 Executive Dr
Ste 209
Raleigh, NC 27609

911 Paverstone Dr
Ste G
Raleigh, NC 27615
Phone (919) 845-7246

3635 Rogers Rd
Wake Forest, NC 27587

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1376287714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 WAKE FOREST RD STE 210",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096864",
            "telephone_number": "919-787-7246",
            "fax_number": "919-787-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2912 MAPLEWOOD AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034010",
            "telephone_number": "336-760-0706",
            "fax_number": "336-760-1927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE SPINE AND PAIN SPECIALISTS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAKE SPINE AND PAIN SPECIALISTS, PC",
        "enumeration_date": "2022-04-22",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "MANDHARE",
        "authorized_official_first_name": "VIJAYSINHA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "919-787-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.